Individual provider Active NPI

Courtney McDermott, OD

  • Optometrist
  • Kokomo, IN
National Provider Identifier
1285206987
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18004290A Issued in IN
Practice address
1601 W Lincoln Rd
Kokomo, IN 46902-3275
Phone
(765) 453-5696
NPI assigned
Jul 13, 2021
Last updated
Jul 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18004290A IN Primary

Addresses

Primary practice location

1601 W Lincoln Rd
Kokomo, IN 46902-3275

Mailing address

1756 Brookside Ave
Indianapolis, IN 46201-1018
Phone (317) 213-6614

Other practice location 1

2705 S Berkley Rd
Kokomo, IN 46902-8025
Phone (765) 453-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210714002056 IN Practitioner - Optometry 0042612988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Eye Consultants PCGroup PAC ID 2961399217, 71 clinicians

Practice addresses (Care Compare)

1601 W Lincoln Rd
Cataract and Laser Institute
Kokomo, IN 46902-3275
Phone (765) 453-5696

Merit-based Incentive Payment System (MIPS)

Final score
55.99 of 100Reported as group
Quality
31.67
Improvement activities
40
Cost
78.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Eye Consultants, PC Optometrist CurrentSince Jul 13, 2021 Accepting new patients
Midwest Eye Consultants, P.C. CurrentSince Jul 13, 2021 Accepting new patients
Midwest Eye Consultants, P.C. Current Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients

Locations

2750 Central Ave
#53
Columbus, IN 47201
Phone (812) 372-4463

1601 W Lincoln Rd
Kokomo, IN 46902
Phone (765) 453-5696

2705 S Berkley Rd
Kokomo, IN 46902
Phone (765) 453-2200

2705 S Berkley Rd
#25
Kokomo, IN 46902
Phone (765) 453-2200

301 J St
Laporte, IN 46350
Phone (219) 326-9569

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1285206987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1756 BROOKSIDE AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462011018",
            "telephone_number": "317-213-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 W LINCOLN RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023275",
            "telephone_number": "765-453-5696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2705 S Berkley Rd",
            "address_purpose": "LOCATION",
            "city": "Kokomo",
            "state": "IN",
            "postal_code": "469028025",
            "country_code": "US",
            "telephone_number": "765-453-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDERMOTT",
        "first_name": "COURTNEY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-13",
        "last_updated": "2021-07-13",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004290A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.